Clinical significance of transesophageal atrial pacing in the diagnosis of tachyarrhythmia

ObjectiveTo investigate the clinical significance of transesophageal atrial pacing in the diagnosis of tachyarrhythmia.

MethodsEighty-five patients with tachyarrhythmia were selected as the study subjects, and the transesophageal atrial pacing of the esophagus was carried out to determine the time limits of R-P'E and P'E-R of esophageal lead.The time limits between R-P' of V1 lead and R-P'E of esophageal lead were compared, and the results of which was compared with the results of the cardiac electrophysiological examination.

ResultsThe tachycardia in all cases were typed after cardiac electrophysiology diagnosing, and the consequent type atrioventricular turn-back core tachycardia(O-AVRT)in 57 cases, slow-fast in atrioventricular node turn-back tachycardia(AVNRT(S-F) in 19 cases, room tachycardia in 1 case, atrial flutter in 1 case, atrial fibrillation in 2 cases, left ventricular idiopathic ventricular tachycardia(ILVT)in 3 cases, AT without coronary sinus origin combined with atrial flutter of right atrial septum origin in the coronary sinus in 1 case, and left atrial AT combined with slow - fast atrioventricular node reentrant tachycardia in 1 cases were found.The results of transesophageal atrial pacing showed that the R-P'E was less than P'E-R, and the R-P'E was less than 70 ms in esophageal lead of AVNRT(S-F)type patient.The R-P'E was less than P'E-R, and the R-P'E was more than 70 ms in most O-AVRT type patients.The R-P' of lead V1 in right side bypass patients was less than R-P'E of esophageal lead, and the R-P' of V1 lead in left side bypass patients was more than R-P'E of esophageal lead.The effective termination rate of tachyarrhythmia was 88% in 85 patients with transesophageal atrial pacing.

ConclusionsThe transesophageal atrial pacing can distinguish the types of tachyarrhythmia, especially the classification of paroxysmal supraventricular tachycardia, which provides help for the rational formulation of follow-up treatment, cardiac electrophysiological examination and radiofrequency ablation.Moreover, the transesophageal atrial pacing has a higher termination rate for tachyarrhythmia.